Carle Jasmin and the American College of Cardiology (Image: AI / Gay Globe)
A question that has divided experts for years
For years, research and studies on alcohol consumption have multiplied and almost always produced contradictory results. One year, red wine is said to be good for blood pressure; the next, it is linked to cancer. The same applies to other wines and spirits.
Now, a large-scale British study (UK Biobank) involving 340,000 adults is changing the conversation.
A major study bringing new answers
According to the medical association, although high alcohol consumption is associated with worse health outcomes regardless of the type of alcohol consumed, the potential effects of low to moderate drinking appear to vary depending on the type of beverage, according to a study presented at the annual scientific session of the American College of Cardiology (ACC.26).
This study, conducted among more than 340,000 British adults, builds on previous research showing that reducing alcohol consumption benefits health and provides new insights into the effects of low to moderate drinking.
“These findings come from the general population, and in certain high-risk groups, such as people with chronic diseases or cardiovascular conditions, the risks could be even higher,” said Zhangling Chen, MD, PhD, professor at the Second Xiangya Hospital of Central South University in China and the study’s lead author.
How researchers analyzed alcohol consumption
Researchers analyzed alcohol consumption habits and mortality outcomes among 340,924 adults who participated in the UK Biobank study between 2006 and 2022. Each participant completed a dietary questionnaire at enrollment and was classified into one of four categories based on alcohol consumption, measured in grams of pure alcohol per day and per week. For reference, a 12-ounce beer, a 5-ounce glass of wine, and a 1.5-ounce serving of spirits each contain approximately 14 grams of pure alcohol. Individuals consuming less than 20 g (about 1.5 standard drinks) per week were classified as abstainers or occasional drinkers. Men consuming between 20 g per week and 20 g per day, and women consuming between 20 g per week and 10 g per day, were considered low consumers. Daily consumption of 20 g to 40 g (about 1.5 to 3 standard drinks) for men and 10 g to 20 g for women was classified as moderate. Daily consumption of more than 40 g (about 3 drinks) for men and more than 20 g (about 1.5 drinks) for women was considered high. Health outcomes were tracked for more than 13 years on average.
Significant differences depending on the type of alcohol
Compared with abstainers or occasional drinkers, individuals with high alcohol consumption had a 24% higher risk of death from all causes, a 36% higher risk of cancer-related death, and a 14% higher risk of death from heart disease. Differences in risk based on the type of alcohol emerge at low and moderate consumption levels: drinking spirits, beer, or cider is associated with a significantly higher risk of death, while an equivalent level of wine consumption is associated with a significantly lower risk.
More specifically regarding cardiovascular deaths, researchers found that moderate wine drinkers had a 21% lower risk of dying from cardiovascular disease compared with abstainers or occasional drinkers. In contrast, even low consumption of spirits, beer, or cider was associated with a 9% higher risk of cardiovascular death compared with no or occasional consumption.
Findings that finally clarify the debate
“Our findings help clarify previously conflicting data on low to moderate alcohol consumption,” Chen said. “They may help refine recommendations by highlighting that alcohol-related health risks depend not only on the amount consumed but also on the type of beverage. Even low to moderate consumption of spirits, beer, or cider is associated with higher mortality, while low to moderate wine consumption may carry a lower risk.”
Why these differences?
According to researchers, several factors may explain these differences depending on the type of alcohol. Certain compounds found in red wine, such as polyphenols and antioxidants, may have beneficial effects on cardiovascular health. Wine is also more often consumed with meals and by individuals with higher-quality diets and generally healthier lifestyles, whereas spirits, beer, and cider are more often consumed outside of meals and are associated with lower overall diet quality as well as other lifestyle-related risk factors.
“Taken together, these elements suggest that the type of alcohol, how it is consumed, and the lifestyle behaviors associated with it all contribute to the observed differences in mortality risk,” Chen added.
A strong study, but with some limitations
In their analyses, researchers adjusted the data to account for demographic factors, socioeconomic status, lifestyle habits, cardiometabolic factors, and family history of diabetes, cardiovascular disease, and cancer. However, they note that this research has limitations inherent to an observational study and suggest that high-quality randomized trials could help better understand the effects of alcohol consumption. Alcohol intake was assessed based on participants’ self-reports at the beginning of the study and does not account for behavioral changes over time. In addition, UK Biobank participants are generally healthier than the broader population, which may limit the generalizability of the findings.
Despite these limitations, the large sample size and long follow-up period strengthen the study’s statistical power. Researchers believe it offers a more comprehensive and nuanced view of alcohol’s effects on health than many previous studies, with a high level of detail regarding both the quantity and type of alcohol consumed, as well as different causes of mortality.
ADVERTISING
